With 48 million families supporting someone in long-term care across the United States,* all too often long-term care becomes the target for illegal activity that leaves the families who were simply trying to care for their loved one at a loss. However, you don’t have to become a victim.
 
TAKE TIME TO UNDERSTAND YOUR LOVED ONE’S ADMISSIONS CONTRACT 
When securing a long-term care facility for your loved one, you will have to decide whether or not to sign an often lengthy and confusing admission contract. Unfortunately, many caregivers do not understand what they are actually signing, thus providing the perfect opportunity for a facility to add illegal clauses that families unknowingly agree to.
 
For example, some admissions contracts include a clause that states a caregiver must pay the resident’s bill in the event that the resident cannot afford to do so. However, clauses like this are generally illegal. Yet, in the event that you unknowingly agreed to this clause in the admission contract, the nursing home can hire debt collectors, including law firms, to demand that you pay the unpaid bills; sometimes even going as far as personally suing you for the outstanding balance or reporting the debt to consumer credit reporting companies under your name.

HOW TO SPOT THE RISKS IN YOUR LOVED
ONE’S CONTRACT 
Oftentimes you may not realize your loved one’s contract includes these clauses until the nursing homes attempts to collect from you personally. If you are already experiencing this pressure from a nursing home, it is important to reach out to a knowledgeable elder law attorney who can review the contract you signed and advise you on the best way to proceed.
 
If you haven’t yet signed a contract, it is a prudent idea to have the agreement reviewed by an expert elder law attorney so they can ensure these clauses are not present. At the very least, pay special attention to verbiage such as “responsible party” or “joint and several liability” in the admissions contract. Some contracts also include language about the caregiver’s liability for a completed Medicaid application or make the caregiver jointly liable with the resident for nursing home bills. In any event, make sure you read the contract thoroughly before you sign it.
 
HOW TO HOLD BAD ACTORS RESPONSIBLE  
You can report the nursing home for violating the Nursing Home Reform Act. To do that, you will need to contact your state’s nursing home survey agency and file a complaint with your state attorney.
 
Finally, if you are having a problem with a debt collector, you can submit a complaint to the CFPB online or by calling (855) 411-2372. 
 
*According to AARP and National Alliance for Caregiving. Caregiving in the United States 2020. Washington, DC: AARP. May 2020. 

What is the federal public health emergency (PHE) and how does it affect Medicaid members?
 
The federal government declared a public health emergency when the COVID-19 pandemic began.  Since then, state agencies have continued health care coverage for all medical assistance programs, even for people who are no longer eligible.
 
When will normal Medicaid processes begin again?
 
States will have 12 months to make sure Medicaid members are still eligible for coverage even though the Public Health Emergency officially ends on April 1, 2023.  However, they will not cancel or reduce coverage for Medicaid members without asking them for updated information.  Denials and closures will begin on April 30, 2023, and everyone will be reviewed by March 2024.  After March 2024, it will be business as usual moving forward. 
 
All renewal Notices of Action will be mailed out this March of 2023 and you will have 30 days to respond once received.  You may have a 90-day grace period to respond if you miss the initial deadline for response. However, you will need to reach out to your caseworker to specifically request an extension if you need more time to respond. 
 
What can you do now?
 
You can:

• Update your contact information online at commonhelp.virginia.gov or by calling Cover Virginia at 1-855-242-8282. They must have current contact information on file, such as a mailing address and phone number(s), so that you receive important notices and so that the Department of Social Services can reach out if they need more information.
• Watch your mail and respond quickly to notices about coverage!
• Sign up for email and text updates, follow them on social media and visit them at coverva.org and facebook.com/coverva/.

 
What if you lost coverage during the PHE?
 
Anyone who lost coverage during the PHE due to administrative reasons needs to complete and submit the renewal paperwork that is requested. The Department of Social Services will process the renewal applications within 30 days and members can call 1-855-242-8282 with any questions.
 
If you would like additional information, please visit coverva.org or facebook.com/coverva/.  You can also call Cover Virginia at 1-855-242-8282 for assistance.